Manipulative-based instructional sequences have proven to be successful with students with disabilities. However, instruction must not only support the acquisition of conceptual and procedural knowledge but also build on students' strengths. This article describes how teachers can use manipulative-based instructional sequences to support the fractional understanding of students who are diagnosed with mathematical learning disabilities. We begin by describing common misconceptions that may affect students' abilities to reason with and calculate fractions. We then explain how teachers can use a concrete-semi-concrete representational-abstract (CRA) model to plan and implement lessons that maximize learning and minimize frustration. Readers are also provided with detailed descriptions of how teachers can assess fraction knowledge, reinforce conceptual understanding, and promote procedural fluency.